Summary

The International Osteoporosis Foundation (IOF) Capture the Fracture® Campaign with the Fragility Fracture Network (FFN) and National Osteoporosis Foundation (NOF) has developed eleven patient-level key performance indicators (KPIs) for fracture liaison services (FLSs) to guide quality improvement.

Introduction

Fracture Liaison Services (FLSs) are recommended worldwide to reduce fracture risk after a sentinel fracture. Given not every FLS is automatically effective, the IOF Capture the Fracture working group has developed and implemented the Best Practice Framework to assess the organisational components of an FLS. We have now developed a complimentary KPI set that extends this assessment of performance to the patient level.

Methods

The Capture the Fracture working group in collaboration with the Fragility Fracture Network Secondary Fragility Fracture Special Interest Group and National Osteoporosis Foundation adapted existing metrics from the UK-based Fracture Liaison Service Database Audit to develop a patient-level KPI set for FLSs.

Results

Eleven KPIs were selected. The proportion of patients: with non-spinal fractures; with spine fractures (detected clinically and radiologically); assessed for fracture risk within 12 weeks of sentinel fracture; having DXA assessment within 12 weeks of sentinel fracture; having falls risk assessment; recommended anti-osteoporosis medication; commenced of strength and balance exercise intervention within 16 weeks of sentinel fracture; monitored within 16 weeks of sentinel fracture; started anti-osteoporosis medication within 16 weeks of sentinel fracture; prescribed anti-osteoporosis medication 52 weeks after sentinel fracture. The final KPI measures data completeness for each of the other KPIs. For these indicators, levels of achievement were set at the < 50%, 50–80% and > 80% levels except for treatment recommendation where a level of 50% was used.

Conclusion

This KPI set compliments the existing Best Practice Framework to support FLSs to examine their own performance using patient-level data. By using this KPI set for local quality improvement cycles, FLSs will be able to efficiently realise the full potential of secondary fracture prevention and improved clinical outcomes for their local populations.

中文翻译：

---

用于衡量骨折联络服务有效性并指导质量改进的患者级关键绩效指标：IOF 捕获骨折工作组、国家骨质疏松症基金会和脆性骨折网络的立场文件。

概括

国际骨质疏松症基金会 (IOF) 与脆性骨折网络 (FFN) 和国家骨质疏松症基金会 (NOF) 合作的 Capture the Fracture® 运动为骨折联络服务 (FLS) 制定了 11 项患者级关键绩效指标 (KPI)，以指导质量改进。

介绍

在全球范围内建议使用骨折联络服务 (FLS)，以降低前哨骨折后的骨折风险。鉴于并非每个 FLS 都会自动生效，IOF 捕获断裂工作组开发并实施了最佳实践框架来评估 FLS 的组织组成部分。我们现在开发了一套免费的 KPI 集，将绩效评估扩展到患者层面。

方法

捕获骨折工作组与脆性骨折网络次要脆性骨折特别兴趣小组和国家骨质疏松症基金会合作，采用了英国骨折联络服务数据库审计的现有指标，为 FLS 制定了患者级 KPI 集。

结果

选择了十一个关键绩效指标。患者比例：非脊柱骨折；脊柱骨折（通过临床和放射学检测）；前哨骨折后 12 周内评估骨折风险；前哨骨折后 12 周内进行 DXA 评估；进行跌倒风险评估；推荐的抗骨质疏松药物；前哨骨折后 16 周内开始力量和平衡运动干预；前哨骨折后 16 周内进行监测；前哨骨折后 16 周内开始抗骨质疏松药物治疗；前哨骨折后 52 周服用抗骨质疏松药物。最终 KPI 衡量其他每个 KPI 的数据完整性。对于这些指标，成就水平设定为 < 50%、50-80% 和 > 80% 水平，但治疗建议使用 50% 的水平除外。

结论

该 KPI 集补充了现有的最佳实践框架，以支持 FLS 使用患者级别的数据检查自己的绩效。通过使用这套用于当地质量改进周期的 KPI，FLS 将能够有效地发挥二级骨折预防的全部潜力，并改善当地人群的临床结果。